Design and Validation of a Novel and Cost-Effective Animal Tissue Model for Training Laparoscopic Adhesiolysis and Mesh Repair of an Incisional Hernia

D. J. Porter (Lead / Corresponding author), Grant Ross, D. Yung, Christopher Payne, Benjie Tang

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Abstract

Objectives: To design and validate a new and cost-effective animal tissue training model for practicing laparoscopic adhesiolysis and mesh repair of an incisional hernia.

Methods and Materials: A laparoscopic training box is mounted with neoprene, which simulates the anterior abdominal wall. The greater curve of a porcine stomach is dissected out and a small circular defect is cut out of the double-layered stomach, this represents the hernial defect. Porcine omentum is stapled around the defect in the stomach, and this represents the adhesions around the incisional hernia.

A Prolene mesh is inserted into the simulated peritoneal cavity under laparoscopic vision and tacked to the anterior abdominal wall.

Face, content, and construct validity of the model was carried out using a 5-point Likert scale questionnaire, and comparison in task performance between course delegates and experts was made using observational and clinical human reliability analysis.

Results: A total of 33 course delegates and 8 expert surgeons were recruited to this study from June 2016 to June 2017. Of the 33 course delegates, 24 were male and 9 were female, with age ranges 27-48 years. Course delegates had between 2 years and 9 years of laparoscopic experience. The mean score on specific feature of the anatomy and colour, sensation of texture, maintenance of pneumoperitoneum and adhesiolysis and mesh fixation was 4.12 ± 0.78, 4.00 ± 0.79, 4.73 ± 0.52, 4.12 ± 0.78 and 4.61 ± 0.56 respectively in the course delegates group, and 4.38 ± 0.52, 4.25 ± 0.71, 4.25 ± 0.71, 4.75 ± 0.46 and 4.75 ± 0.46 respectively in the expert surgeon group on a scale of 1 (unrealistic) and 5 (very realistic).

Conclusion: A newly designed restructured animal tissue model for training laparoscopic adhesiolysis and mesh repair of an incisional hernia is reported. Validation studies on the model demonstrate that this is a very realistic and effective model for skills training in laparoscopic adhesiolysis and mesh repair of an incisional hernia.

As a result of this laparoscopic training model course delegates reported that they had gained transferrable operating skills and increased confidence in the performance of laparoscopic adhesiolysis and incisional hernia repair with mesh.

This training model is an effective and cost-efficient laparoscopic training simulator.
Original languageEnglish
Article number1062
Pages (from-to)1-5
Number of pages5
JournalWorld Journal of Surgery and Surgical Research
Volume1
Publication statusPublished - 20 Sep 2018

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Keywords

  • Animal tissue model
  • Simulation training
  • Training model validity
  • Laparoscopic adhesiolysis
  • Incisinal hernia repair

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